Rofo 2014; 186 - VO403_7
DOI: 10.1055/s-0034-1372785

MRI-guided Electrophysiological Interventions in Swine using Active Tracking and passive Catheter Visualization

M Grothoff 1, C Piorkowski 2, P Sommer 3, G Hindricks 3, L Lehmkuhl 4, M Gutberlet 4
  • 1Universität Leipzig – Herzzentrum, Radiologie, Leipzig
  • 2University of Dresden, Heart Center, Electrophysiology, Dresden
  • 3University of Leipzig, Heart Center, Electrophysiology, Leipzig
  • 4University of Leipzig, Heart Center, Radiology, Leipzig

Zielsetzung:

Electrophysiological (EP) procedures guided by MRI have the potential of improving catheter navigation and of characterizing tissue changes. Here we present the results of a series of ablation studies using a combination of active catheter tracking and real-time catheter imaging.

Material und Methodik:

A 3D data set containing the heart was acquired in 8 swine using a 1.5T MR-scanner and a 3D-sequence. An MR-EP-platform (iSuite, Philips Research Hamburg) created 3D-models of all cardiac chambers. Two MRI conditional catheters (Vision, Imricor Medical Systems) were inserted via femoral sheaths. Active catheter tracking was performed using the magnetic field to localize inductive coils on the EP-catheter. The positions of the catheter tip were confirmed by steady-state-free-precession (SSFP) sequences.

Ablation procedures were performed alternately in the PVs and the cavotricuspidal isthmus.

Ergebnisse:

The protocol could be completed in all swine using active tracking mostly. The intubation of the CS was possible by active tracking only in one pig, in all the others passive real-time imaging in an LAO equivalent orientation was helpful to visualize the angle between the IVC and the CS, and to advance the catheter. Transseptal puncture was successful with a mean procedural time of 16.4 ± 10.1 minutes in all experiments. The position of the catheter tip as visualized by active tracking could reliably be confirmed with passive real-time imaging.

Schlussfolgerungen:

The combination of active catheter tracking and passive real-time visualization in MR-guided EP-studies using advanced interventional software like the iSuite was safe and enabled efficient navigation, mapping and ablation. Beneath the radiation free environment additive values of this technique might be the visualization of the ablation induced tissue damage, what further has to be evaluated.

E-Mail: grothoff@gmx.de